For example, in April 2012, for hemodialysis patients with a hemoglobin level below 9 g/dL, the proportion of those who received transfusions was 16% for ESA users compared with 27.6% of non-users. The proportions, respectively, were 16.1% and 5.4% for patients with hemoglobin levels of at least 9 but less than 10 g/dL.

Transfusion use was similar for ESA users and non-users when hemoglobin levels were at least 10 but less than 12 g/dL. Investigators observed similar patterns during the months from May through December.

Researchers Allan J. Collins, MD, and collaborators at the Chronic Disease Research Group in Minneapolis, Minn., noted that evaluation of hemoglobin levels and transfusion use had been possible only for ESA-treated patients as a result of Medicare reporting requirements.

The Centers for Medicare and Medicaid Services in 2012 started requiring hemoglobin levels to be reported for all dialysis patients.